G018 – Estradiol
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
An in-office laboratory test for Estradiol. Per the 'LABORATORY MEDICINE IN PHYSICIAN'S OFFICE' definition on page , this service is only payable when rendered by a physician in their own office for their own patient. It is not insured when rendered to support in-vitro fertilization or artificial insemination services. Medical records must document the test result, the physician's interpretation, and the treatment decision based on the results.
When to Use
- Use G018 when performing an in-office point-of-care estradiol test to monitor hormonal status for non-fertility related conditions such as managing menopausal symptoms or monitoring hormone replacement therapy.
- Utilize this code when the test is performed personally by the physician or their staff in the office setting for immediate clinical decision-making, rather than sending the sample to an external laboratory.
Common Pitfalls
- Billing G018 for patients undergoing fertility treatments, such as IVF or artificial insemination, will result in automatic rejection as these services are explicitly excluded under Regulation 552.
- Submitting G018 for tests performed by an external laboratory or a licensed specimen collection center is a billing error; those services must be billed by the laboratory facility, not the physician.
- Failure to document the specific numerical result and the subsequent clinical action taken in the chart will lead to full recovery of the fee during a Ministry audit.
Billing Tips
- Ensure the chart note explicitly links the G018 result to a specific treatment adjustment or clinical decision to satisfy the mandatory documentation requirements for laboratory services in the physician's office.
Effective: April 1, 2026
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Laboratory
Diagnostic and Therapeutic Procedures
Laboratory services are only eligible for payment if the result of the test(s), the physician's interpretation of the results of the test(s) and the treatment decision based on the test results are documented in the patient's permanent medical record.
A laboratory service (“test”) set out in this section is an insured service eligible for payment only when rendered by a physician (“the original physician”), or by a physician substituting for the original physician, who performs the test in the original physician's own office for the physician's own patient.
Tests listed under 'Reproductive medicine' and 'Point of care drug testing' are only payable to those physicians where point of care testing is necessary for their practice.
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